Prof. Keiji Fukuda retired in 2021 as Director, School of Public Health, University of Hong Kong. He previously served at WHO as Assistant Director General for Health Security and Director, Global Influenza Programme and at the U.S. CDC as Epidemiology Chief, Influenza Branch. He trained in internal medicine and then worked on areas including health security and emerging infectious diseases, research, national public health systems, media communications, health diplomacy and teaching. He helped define the Chronic Fatigue Syndrome and helped investigate and manage notable infectious disease outbreaks, including avian influenza H5N1 (Hong Kong), avian influenza H7N9 and SARS (Mainland China), MERS (Saudi Arabia and South Korea) and Ebola (West Africa). He managed WHO’s global response to the 2009 H1N1 influenza pandemic, the Pandemic Influenza Preparedness Framework and the International Health Regulations. During COVID-19, he advised the Hong Kong Government and now is on the Boards of CMB, RIGHT Foundation and Ending Pandemics.

Abstract
The world has repeatedly experienced major outbreaks of infectious diseases, including pandemics, through history. COVID-19 is the outstanding recent example of such an event because it severely disrupted the well-being and functioning of virtually all countries and communities. Although it stands as a very notable example, regarding COVID-19 as an isolated or unique “one off” event would be a significant strategic error for national planners because history and contemporary science strongly suggest that future outbreaks and pandemics can be anticipated, and some could prove more disruptive. In this context, a constructive approach is to use insights gained from COVID-19 and other major events as guidance for how countries, including Japan, may prepare better for future events.

Past efforts over decades to be better prepared include multilateral efforts such as adoption of international agreements, including the International Health Regulations and the Pandemic Influenza Preparedness Framework, and current negotiations over a so-called “pandemic treaty.” Domestically, many disparate approaches towards “pandemic preparedness” have been used by different countries, ranging from detailed operational planning to more generalized “capacity building” efforts. Many such efforts lose momentum from lack of continued political or financial support.

Such efforts have spanned decades, and yet COVID-19 demonstrated that many countries were poorly prepared. Many were hesitant or unsure in their decision making or appeared to ignore available scientific evidence. Many struggled with the implementation of core public health measure such as infection testing and monitoring and the application of prevention and control measures. Many also did not anticipate supply chain issues resulting in the lack of sufficient critical supplies, such as masks. Policy approaches to activities such as quarantine and lock downs, border control and travel measures and international cooperation, including vaccine sharing and cooperation with WHO, were inconsistent, at best.

The speaker will discuss such issues but will focus most on what he believes would be helpful going forward. He has extensive experience working on major outbreaks and pandemic preparedness at national and global levels as well as the development and application of relevant international frameworks. He will discuss the importance of positioning preparedness so it might be supported more consistently, of focusing on core and consistent functional challenges as the basis for preparedness, and the critical need for functional multilateral agreements and relations. The latter are in jeopardy, however, given the current geopolitical climate. The speaker managed the WHO’s response to the 2009 pandemic, worked with many countries on preparedness and during COVID-19, was on multiple scientific and strategic advisory committees to the Government in Hong Kong.